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SPIRAL FIELDS OF VISION AND NEURASTHENIA
624 the commencement of treatment, which dose was repeated in the course of a few hours when coma or other urgent symptoms were present, and under continued energetic treatment even the apparently most desperate cases recovered. For instance, I had a man in my wards who lay in deep and stertorous coma for over 36 hours and who ultimately made a good recovery under large doses of quinine bi-hydrochloride given in this way, 90 grains being administered in 24 hours. This is a large dose and one that I, personally never exceeded ; but I have been shown cases in a foreign hospital where the maximum daily dose was 8 grammes (120 grains) given by intravenous injection, and the responsible medicaltOSicer in charge was himself a resident of a highly malarious country and possessed a wide experience in the treatment of the disease. It would be interesting to know whether, when such doses have been constantly employed, anything other than good results have been obtained in severe cases of malaria. But by no means all cases of malaria are severe, and there are malarious countries where other means of treatment are also resorted to. I have seen a peasant with a temperature of 104° F., who was suffering from both malaria and dysentery, standing to sluice bis head and chest with cold water, although he was almost too weak to crawl out of bed at all; and others, too ill to rise, have called out daily for the same thing. This belief in the efficacy of cold water is doubtless the result of experience and of the teaching of Priessnitz and his followers during the first half of last century, but it is not merely a local doctrine; for at the time that I found these peasants applying this line of treatment for themselves it was interesting to read in THE LANCET (1916) reports of successful hydrotherapeutic measures in the treatment of malaria in Switzerland.
NEURASTHENIA
To tAe Editor of THE LANCET. SIR,-Your review of Jones and Llewellyn’s book on Malingering," in your issue of August 4th, raises an in-
teresting point regarding helicoid curves in the chapter For while I have attributed on the eye, contributed by me. spiral fields of vision to neurasthenia and not to hysteria, your reviewer believes that the converse is usually taught. The helicoid appearance is, I think, universally considered to be due to the abnormally quickly induced fatigue typical of neurasthenic subjects. I do not dispute the statement that helicoid fields were first observed in hysteria, but it is well recognised that neurasthenia may be associated with hysteria, and the peculiar field may, with plausibility, be referred to the neurasthenic element. I think all authorities agree that if suggestibility be the salient feature of hysteria, " fatigabilityis the core of neurasthenia, and therefore a fatigue field is more characteristic of the latter syndrome. I am, Sir, yours faithfully, W. M. BEAUMONT. Bath, Oct. 13th, 1917.
THE SERVICES. ROYAL NAVAL MEDICAL SERVICE. P. Macarthur to be
it is
precisely
those
ARMY MEDICAL SERVICE.
Promotion, and to be supernumerary. Lieut.-Col. H. G. Barling, C.B., R.A.M.C.,T.F., to be Colonel.
cases
temporary
--
ROYAL ARMY MEDICAL CORPS. T. B. Futcher, C.A.M.C., to be temporary Lieutenant-Colonel. Temp. Major C. Brown, Canadian Army Dental Corps, to be temporary Lieutenant-Colonel while specially employed. Temp. Hon. Major E. W. Wnite to be temporary honorary Lieutenant-Colonel. Temp. Hon. Lieut.-Col. L. C. Parkes (Major, R.A.M.C., T.F.) relinquishes his temporary honorary rank. Lieut.-Col. T. E. Sandall, Lincolnshire Regiment, T.F., to be temporary I Lieutenant-Colonel. Capt. E. D. Caddell and Major B. H. V. Dunbar, D.S.O., relinquish the acting rank of Lieutenant-Colonel on reposting. Temp. Major G. J. Boyce. C.A.M.C., to be acting Lieutenant-Colonel. Temp. Major(Capt., R.A.M.C. T.F.) F. A. Hepworth relinquishes his rank on reposting. Temp. Capts. (C.A.M.C.) G. W. Treleeven and S. G. Ross to be acting
temporary Majors.
Temp. Capt. F. F. Middleweek to be temporary Major whilst commanding troops on a hospital ship. Temp. Hon. Lieut. Sir F. M. Farmer to be temporary Honorary Major. B. Lyons to be temporary Captain. : Temporary Lieutenants to be temporary Captains : R. T. Worthington, V. Colmer, F. J. Colling, A. G. Gilchrist, G. E. Lloyd, J. Bradley-
i
Hughes, H. H.
Late temporary Lieutenant R.A.M.C. 1917.
F. W. Harrowell.
Scott, late temporary Captain,
is
granted
the
honorary rank of
Captain. A. Renshaw to be temporary Honorary Captain whilst employed with Hospital, Netley. theR.Welsh Gellatly to be temporary Lieutenant whilst serving at the
-
Torquay, Oct. 16th,
temporary Surgeon.
Surg.-Gen. R. H. S. Sawyer, C.M.G., is retained on the Active List under the provisions of Articles 120 and 522, Royal Warrant for Pay and
with latent infections, in which, as already stated, quinine alone gives such disappointing results, that derive benefit from treatment by baths of various kinds. If hydrotherapy has any influence at all, and there must be few who would deny that it has, it is surely to be expected that this would be demonstrated in just such a condition, in which liver, spleen, and other internal organs form the resting place for the infecting organism, which is ready to reassert itself whenever general conditions may be favourable for it to do so. For such a line of treatment, and especially at the present time, it may fairly be claimed that Torquay is peculiarly adapted, both by reason of its distinctive situation and on account of the thoroughly complete and up-to-date bathing establishment that has lately been installed by the authorities, in which all baths and douches--hot and cold, local and general-can be administered with either salt water or with the exceptionally soft water from Dartmoor. I am, Sir, yours faithfully, A. E. CARVER,
Possibly
’
SPIRAL FIELDS OF VISION AND
,
Huddersiield War Hospital. To be temporary Lieutenants : R. Edridge, A. J. B. Leckie, J. Crean, Fleming, A. F. Miller, W. McQuiban, T. F. Ryan, F. P. B. MacTavish, E. W. Goble, J. G. Lessey, J. McNamara, J. Magner, W. Lovell. W. Murphy, P. D. Maclean, R. W. H. Meredith, W. H. C. Patrick, H. E. Alexander, K. H. Dyke, A. H. L. Thomas, S. M. Green, R. T. Edwards, S. W. Matthews, D. Wardrop, J. B. C. Brockwell, A. B. Fearnley, J. C. D. Allan, W. Bain. A. C. Delacroix to be temporary Honorary Lieutenant. Officers relinquishing their commissions :-Temporary Captains : D. McD. Wilson, T. Redmayne, R. H. L. O’Callaghan. T. R. Davey (on account of ill-healtb), P. M. Turnbull, F. G. Martin (granted honorary rank of Captain). Temporary Lieutenants : K. B. Allan, J. Pugh. Temp. Capt. W. J. Bell, C.A.M.C., resigns his temporary commission.
THE ANNUAL MEETING OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND.
H. McC.
of THE LANCET. of the Royal College of of Members SIR,-The Society Surgeons of England addressed a letter to the Council of the Royal College of Surgeons of England respectfully suggesting that, in view of the present great pressure on the time and money of medical men at home, and the absence of so many of our members abroad on His Majesty’s service, the annual meeting of Fellows and Members at the College should not be held this year, the Society reserving its advocacy of the This cause of the Members for future suitable occasions. suggestion was considered at a meeting of the Council of the College on Oct. llth, when it was decided to proceed with preparations for the annual meeting on the usual lines. We think that this decision is regrettable, as many Members will be unable to attend, while the expenses associated with the meeting might have been saved to the College funds. I am, Sir, yours faithfully, SIDNEY C. LAWRENCE, Honorary Secretary, Society of Members of the Royal College of Surgeons of England. To the Editor
Oct. 14th, 1917
SPECIAL RESERVE OF OFFICERS.
Capt W. H. L. McCarthy relinquishes the acting rank ofLieutenantColonel on reposting. Capt. W. McCombie to be acting Lieutenant-Colonel whilst in com-
mand of a Field Ambulance. Lieutenents to be Captains : F M. Rorie, J. A. W. Cullen. To be Lieutenants : Second Lieutenant G. R. Sharp (from Unattached List, T.F.), D. E. Hearn (from Durham University Contingent O.T.C.). TERRITORIAL FORCE.
Capt. W. B. Keith is seconded whilst holding an appointment as Deputy Assistant Director of Medical Services, and Capt. R. C. Canney is seconded for duty with a General Hospital. Capt. (temp. Major) W. S. Coiman relinquishes his temporary rank and is restored to the Establishment.
W. J. Smvth (late Surgeon Captain, A. M.S.) to be temporary Major, Medical Volunteer Corps. S. P. Matthews to be temporary Lieutenant and Medical Officer, 8th Battalion Sussex Volunteer Regiment.
Hampshire
,
NEURASTHENIA
To tAe Editor of THE LANCET. SIR,-Your review of Jones and Llewellyn’s book on Malingering," in your issue of August 4th, raises an in-
teresting point regarding helicoid curves in the chapter For while I have attributed on the eye, contributed by me. spiral fields of vision to neurasthenia and not to hysteria, your reviewer believes that the converse is usually taught. The helicoid appearance is, I think, universally considered to be due to the abnormally quickly induced fatigue typical of neurasthenic subjects. I do not dispute the statement that helicoid fields were first observed in hysteria, but it is well recognised that neurasthenia may be associated with hysteria, and the peculiar field may, with plausibility, be referred to the neurasthenic element. I think all authorities agree that if suggestibility be the salient feature of hysteria, " fatigabilityis the core of neurasthenia, and therefore a fatigue field is more characteristic of the latter syndrome. I am, Sir, yours faithfully, W. M. BEAUMONT. Bath, Oct. 13th, 1917.
THE SERVICES. ROYAL NAVAL MEDICAL SERVICE. P. Macarthur to be
it is
precisely
those
ARMY MEDICAL SERVICE.
Promotion, and to be supernumerary. Lieut.-Col. H. G. Barling, C.B., R.A.M.C.,T.F., to be Colonel.
cases
temporary
--
ROYAL ARMY MEDICAL CORPS. T. B. Futcher, C.A.M.C., to be temporary Lieutenant-Colonel. Temp. Major C. Brown, Canadian Army Dental Corps, to be temporary Lieutenant-Colonel while specially employed. Temp. Hon. Major E. W. Wnite to be temporary honorary Lieutenant-Colonel. Temp. Hon. Lieut.-Col. L. C. Parkes (Major, R.A.M.C., T.F.) relinquishes his temporary honorary rank. Lieut.-Col. T. E. Sandall, Lincolnshire Regiment, T.F., to be temporary I Lieutenant-Colonel. Capt. E. D. Caddell and Major B. H. V. Dunbar, D.S.O., relinquish the acting rank of Lieutenant-Colonel on reposting. Temp. Major G. J. Boyce. C.A.M.C., to be acting Lieutenant-Colonel. Temp. Major(Capt., R.A.M.C. T.F.) F. A. Hepworth relinquishes his rank on reposting. Temp. Capts. (C.A.M.C.) G. W. Treleeven and S. G. Ross to be acting
temporary Majors.
Temp. Capt. F. F. Middleweek to be temporary Major whilst commanding troops on a hospital ship. Temp. Hon. Lieut. Sir F. M. Farmer to be temporary Honorary Major. B. Lyons to be temporary Captain. : Temporary Lieutenants to be temporary Captains : R. T. Worthington, V. Colmer, F. J. Colling, A. G. Gilchrist, G. E. Lloyd, J. Bradley-
i
Hughes, H. H.
Late temporary Lieutenant R.A.M.C. 1917.
F. W. Harrowell.
Scott, late temporary Captain,
is
granted
the
honorary rank of
Captain. A. Renshaw to be temporary Honorary Captain whilst employed with Hospital, Netley. theR.Welsh Gellatly to be temporary Lieutenant whilst serving at the
-
Torquay, Oct. 16th,
temporary Surgeon.
Surg.-Gen. R. H. S. Sawyer, C.M.G., is retained on the Active List under the provisions of Articles 120 and 522, Royal Warrant for Pay and
with latent infections, in which, as already stated, quinine alone gives such disappointing results, that derive benefit from treatment by baths of various kinds. If hydrotherapy has any influence at all, and there must be few who would deny that it has, it is surely to be expected that this would be demonstrated in just such a condition, in which liver, spleen, and other internal organs form the resting place for the infecting organism, which is ready to reassert itself whenever general conditions may be favourable for it to do so. For such a line of treatment, and especially at the present time, it may fairly be claimed that Torquay is peculiarly adapted, both by reason of its distinctive situation and on account of the thoroughly complete and up-to-date bathing establishment that has lately been installed by the authorities, in which all baths and douches--hot and cold, local and general-can be administered with either salt water or with the exceptionally soft water from Dartmoor. I am, Sir, yours faithfully, A. E. CARVER,
Possibly
’
SPIRAL FIELDS OF VISION AND
,
Huddersiield War Hospital. To be temporary Lieutenants : R. Edridge, A. J. B. Leckie, J. Crean, Fleming, A. F. Miller, W. McQuiban, T. F. Ryan, F. P. B. MacTavish, E. W. Goble, J. G. Lessey, J. McNamara, J. Magner, W. Lovell. W. Murphy, P. D. Maclean, R. W. H. Meredith, W. H. C. Patrick, H. E. Alexander, K. H. Dyke, A. H. L. Thomas, S. M. Green, R. T. Edwards, S. W. Matthews, D. Wardrop, J. B. C. Brockwell, A. B. Fearnley, J. C. D. Allan, W. Bain. A. C. Delacroix to be temporary Honorary Lieutenant. Officers relinquishing their commissions :-Temporary Captains : D. McD. Wilson, T. Redmayne, R. H. L. O’Callaghan. T. R. Davey (on account of ill-healtb), P. M. Turnbull, F. G. Martin (granted honorary rank of Captain). Temporary Lieutenants : K. B. Allan, J. Pugh. Temp. Capt. W. J. Bell, C.A.M.C., resigns his temporary commission.
THE ANNUAL MEETING OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND.
H. McC.
of THE LANCET. of the Royal College of of Members SIR,-The Society Surgeons of England addressed a letter to the Council of the Royal College of Surgeons of England respectfully suggesting that, in view of the present great pressure on the time and money of medical men at home, and the absence of so many of our members abroad on His Majesty’s service, the annual meeting of Fellows and Members at the College should not be held this year, the Society reserving its advocacy of the This cause of the Members for future suitable occasions. suggestion was considered at a meeting of the Council of the College on Oct. llth, when it was decided to proceed with preparations for the annual meeting on the usual lines. We think that this decision is regrettable, as many Members will be unable to attend, while the expenses associated with the meeting might have been saved to the College funds. I am, Sir, yours faithfully, SIDNEY C. LAWRENCE, Honorary Secretary, Society of Members of the Royal College of Surgeons of England. To the Editor
Oct. 14th, 1917
SPECIAL RESERVE OF OFFICERS.
Capt W. H. L. McCarthy relinquishes the acting rank ofLieutenantColonel on reposting. Capt. W. McCombie to be acting Lieutenant-Colonel whilst in com-
mand of a Field Ambulance. Lieutenents to be Captains : F M. Rorie, J. A. W. Cullen. To be Lieutenants : Second Lieutenant G. R. Sharp (from Unattached List, T.F.), D. E. Hearn (from Durham University Contingent O.T.C.). TERRITORIAL FORCE.
Capt. W. B. Keith is seconded whilst holding an appointment as Deputy Assistant Director of Medical Services, and Capt. R. C. Canney is seconded for duty with a General Hospital. Capt. (temp. Major) W. S. Coiman relinquishes his temporary rank and is restored to the Establishment.
W. J. Smvth (late Surgeon Captain, A. M.S.) to be temporary Major, Medical Volunteer Corps. S. P. Matthews to be temporary Lieutenant and Medical Officer, 8th Battalion Sussex Volunteer Regiment.
Hampshire
,